[contactform email=”chris@kosovichmedia.com”]
[textfield label=”Name & Hailing Port”]
[textfield label=”Year & Make”]
[textfield label=”Length”]
[select label=”Type” value=”Dinghy, Inflatable, Kayak, Rigid Inflatable, Rowboat, Sailboat”]
[select label=”Hull Material” value=”Aluminum, Fiberglass, Plastic”]
[textfield label=”Color”]
[textfield label=”Prominent Features”]
[fancy_header variation=”black”]Propulsion[/fancy_header]
[select label=”Primary Propulsion” value=”Diesel IB, Electric OB, Gas IB, Gas IO, Gas OB, Oar, Paddle, Wind”]
[select label=”Auxiliary Propulsion” value=”Diesel IB, Electric OB, Gas IB, Gas IO, Gas OB, Oar, Paddle, Wind”]
[select label=”Radio 1 Type” value=”VHF-FM”]
[textfield label=”Radio 1 – Ch./Freq. Monitored”]
[select label=”Radio 2 Type” value=”VHF-FM”]
[textfield label=”Radio 2 – Ch./Freq. Monitored”]
[textfield label=”Mobile Phone Number”]
[checkbox label=”Maps”]
[checkbox label=”Charts”]
[checkbox label=”Compass”]
[checkbox label=”GPS”]
[textfield label=”Other navigation tools”]
[checkbox label=”Electric S-O-S Light”]
[checkbox label=”Orange Flag”]
[checkbox label=”Orange Smoke”]
[checkbox label=”Red Flares”]
[checkbox label=”Bell”]
[checkbox label=”Horn / Siren”]
[checkbox label=”Whistle”]
[textfield label=”Quantity of PFDs On Board”]
[checkbox label=”Anchor”]
[checkbox label=”Fire Extinguisher”]
[checkbox label=”Flashlight / Searchlight”]
[checkbox label=”Food and Water”]
[textfield label=”Number of days of food and water”]
[checkbox label=”Foul Weather Gear”]
[checkbox label=”Signal Mirror”]
[textfield label=”Other Special Gear”]
[textfield label=”Operator Name”]
[textfield label=”Operator Age”]
[/contactform]